Individual provider Active NPI

Mahmoud Khaled Abdelghaffar, MD

  • Anesthesiology Physician
  • Cheverly, MD
National Provider Identifier
1306408570
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
72438 Issued in CT
Practice address
3001 Hospital Dr
Cheverly, MD 20785-1189
Phone
(301) 618-2273
NPI assigned
Jul 8, 2019
Last updated
Oct 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X 72438 CT Primary

Addresses

Primary practice location

3001 Hospital Dr
Cheverly, MD 20785-1189

Mailing address

99 E River Dr FL 5
East Hartford, CT 06108-7301
Phone (860) 282-4104

Other practice location 1

2 Corporate Dr Fl 9
Shelton, CT 06484-6238
Phone (203) 929-7353

Other practice location 2

80 Seymour St
Hartford, CT 06102-8000
Phone (203) 929-7353

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230608001476 CT Practitioner - Anesthesiology 3971960881 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Anesthesia Associates LLCGroup PAC ID 1759281165, 402 clinicians

Practice addresses (Care Compare)

80 Semour St
Hartford, CT 06106-3315
Phone (860) 972-2117

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
72438CTMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Anesthesia Associates LLC Anesthesiology CurrentSince Jul 1, 2023 Accepting new patients

Locations

80 Seymour St
Hartford, CT 06106
Phone (860) 545-2249

99 E River Dr
Fl 5
Hartford, CT 06108
Phone (860) 282-4022

2 Corporate Dr
Fl 9
Shelton, CT 06484
Phone (203) 929-7375

2 Corporate Dr
Ste 955
Shelton, CT 06484
Phone (203) 929-7375

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1306408570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 E RIVER DR FL 5",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061087301",
            "telephone_number": "860-282-4104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 HOSPITAL DR",
            "city": "CHEVERLY",
            "state": "MD",
            "postal_code": "207851189",
            "telephone_number": "301-618-2273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Corporate Dr Fl 9",
            "address_purpose": "LOCATION",
            "city": "Shelton",
            "state": "CT",
            "postal_code": "064846238",
            "country_code": "US",
            "telephone_number": "203-929-7353",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "80 Seymour St",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061028000",
            "country_code": "US",
            "telephone_number": "203-929-7353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABDELGHAFFAR",
        "first_name": "MAHMOUD",
        "middle_name": "KHALED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-08",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CT",
            "license": "72438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheverly, MD

Sources for this page

Verify at the official NPI Registry.